Case Management

Children

• Case Management Checklist (pdf) - Easy step-by-step checklist for case management activities
• Oregon Case Management Flow Chart (pdf) - Flow chart for childhood case management
•  Consent and release form  - modify as needed

•  Notice to family of 5-9 micrograms per deciliter result - modify as needed
• Unconfirmed EBLL - letter to family regarding an ( English,  Spanish) - modify as needed

Adults

• Patient Questionnaire (pdf) - To be used by OHA, County Health Department and Clinic staff to help patients identify and control sources of lead exposure.
• Medical Provider Questionnaire (pdf) - To be used by OHA and County Health Departments to determine possible lead sources.

Medical Management for Providers and County Health Department Staff 

Children 

• Medical Information Form (pdf) - For children with elevated blood lead levels: County Health Departments contact the medical provider and have them complete this form. Copy of completed form needs to be sent to OHA along with all case management documentation.
• Medical Evaluation and Recommendations (pdf) - For children with elevated blood lead levels (EBLLs). This document is intended to provide evidence-based guidance for medical providers caring for children with confirmed EBLLs.

Adults

• Understanding Blood Lead Testing Results for Adult Exposure to Lead (pdf)- Information on types of blood lead testing and interpretation of test results. Intended for medical providers or county health department staff.
• Recommended Adult Medical Evaluation for Lead Exposure (pdf)- Interview form used by medical provider to identify and care for elevated blood lead levels.
• Medical Evaluation and Recommendations (pdf) - For adults with elevated blood lead levels (EBLLs). This document is intended to provide evidence-based guidance for medical providers caring for adults with confirmed EBLLs.

Environmental Investigation

• Environmental Investigative Procedures: For Homes of Children with Elevated Blood Lead Levels (pdf).
• Environmental Questionnaire (pdf) -Questionnaire used to identify possible source(s) and environmental sampling locations
• Environmental Sampling Protocol (pdf) - Protocols for environmental sampling during on-site investigations
• Floor Plan Graph Paper (pdf) - For use during on-site investigations. Plot sampling locations and possible lead hazards
• Sending in Environmental Samples (pdf) - Directions for sending in environmental samples taken during on-site investigations of lead poisoning cases
• Letter to family with environmental investigation results ( English,  Spanish) - modify as needed
•  Letter to landlord or property owner regarding environmental investigation results - modify as needed